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Ismail F, Haq S, Hasan TS, Juoda D, Abdelsameea E, El-Garawani I, Hathout HMR. Hepatitis B Virus Infection in Eastern Libya: Current Efforts for Overcoming Regional Barriers for Its Elimination. J Community Health 2024; 49:693-699. [PMID: 38393652 DOI: 10.1007/s10900-024-01339-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
Approximately 2.2% of Libyans have chronic hepatitis B (CHB) and are at the highest risk of developing end-stage disease complications. Several resource-limited countries, including Libya, may be far from achieving the WHO goal of hepatitis B elimination by 2030 as a result of several testing and linkage to care (LTC) barriers. In Libya, data about the current HBV infection situation is scarce. Therefore, our study aimed to evaluate the trends of HBV in eastern Libya, Tobruk region, and try to identify the region-specific gaps and barriers that could potentially delay the WHO goal of HBV elimination. An eighteen-year retrospective review of records of the main district medical center in the region was done to estimate the trends of HBV infection and qualitative interviews with the clinical staff of the CHB registry in the region were conducted to investigate the current status of HBV management. Out of 392,952 records, 371 (0.09%) HBV-positive were recorded and declining trends of the infection were noticed over the study period. Until late 2019, there was no linkage to care or follow-up for people with HBV infection. However, a CHB registry was established in late 2019 to manage HBV infections in the region, yet there are several barriers such as the lack of diagnostic infrastructure for liver function assessment and antiviral treatment. Despite the significant decline observed in the occurrence of HBV infection and introduction of important HBV management steps such as establishment of the CHB registry, there are still several barriers that could delay the elimination of the infection.
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Affiliation(s)
- Faisal Ismail
- Department of Clinical Laboratory, Faculty of Medical Technology, University of Tobruk, Tobruk, Libya.
- Blood Transmitted Diseases Department, National Centre for Disease Control, Tobruk, Libya.
- Infectious Diseases Department, Libyan Medical Research Centre, Kambut, Tobruk, Libya.
| | - Soghra Haq
- Department of Clinical Laboratory, Faculty of Medical Technology, University of Tobruk, Tobruk, Libya
| | - Tarik Salih Hasan
- Chronic Hepatitis B Registry Department, Liver Disease Centre, Tobruk, Libya
| | - Doaa Juoda
- Chronic Hepatitis B Registry Department, Liver Disease Centre, Tobruk, Libya
| | - Eman Abdelsameea
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Shebin El-Kom, Egypt
| | - Islam El-Garawani
- Zoology Department, Faculty of Science, Menoufia University, Shebin El-Kom, Egypt
| | - Heba M R Hathout
- Natural Resources Department, Faculty of African Postgraduate Studies, Cairo University, Cairo, Egypt
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Sammour AAK, Elijla Y, Alsarafandi M, Aldabbour B, Kanou L, Almaidana F, El Egla M, Harara S, Oda S, Albardaweel N, Skaik A. Knowledge, Attitude and Practice Among Palestinian Healthcare Workers in the Gaza Strip Towards Hepatitis B: Cross-sectional survey. Sultan Qaboos Univ Med J 2023; 23:370-379. [PMID: 37655075 PMCID: PMC10467557 DOI: 10.18295/squmj.1.2023.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/24/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
Objectives Healthcare workers are at high risk of contracting hepatitis B virus (HBV). This survey aimed to identify the gaps and strengths in the knowledge, attitudes and practices of healthcare workers towards HBV to drive appropriate health interventions. Methods This cross-sectional study was conducted between March and April 2022. A convenience sample of three at-risk healthcare professions from the major health facilities in Gaza was surveyed. A 40-item self-administered questionnaire was used. Statistical data analysis was conducted using Statistical Package for Social Sciences version 25 to obtain descriptive and inferential statistics via various nonparametric, correlation and regression tests (with P <0.05). Results A total of 447 healthcare workers participated in the study. Overall, 105 of the participants (23.5%) demonstrated poor knowledge (below 14/20 points) of HBV, 284 (63.5%) had moderate knowledge (14-17 points) and 58 (13%) showed good knowledge. The majority (n = 367, 82.1%) expressed an excellent attitude. Finally, 287 (64.2%) demonstrated a good level of practice regarding HBV infection. A history of needlestick injury was reported by 233 (52.1%) participants, 170 (73.3%) of whom reported taking appropriate preventive actions after exposure. Conclusion The majority of the participants demonstrated overall good knowledge regarding HBV infection. Nonetheless, significant gaps remain in the different aspects of the knowledge, attitude and practice construct that require appropriate awareness campaigns to further limit the spread of this preventable viral infection.
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Affiliation(s)
| | - Younis Elijla
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Muath Alsarafandi
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Belal Aldabbour
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Loay Kanou
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Fahmy Almaidana
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Moataz El Egla
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Samah Harara
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Seham Oda
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Nour Albardaweel
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
| | - Adnan Skaik
- Faculty of Medicine, Islamic University of Gaza, Gaza, State of Palestine
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Gur-Arie R, Davidovitch N, Rosenthal A. Intervention hesitancy among healthcare personnel: conceptualizing beyond vaccine hesitancy. Monash Bioeth Rev 2022; 40:171-187. [PMID: 35306625 PMCID: PMC8934537 DOI: 10.1007/s40592-022-00152-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/18/2021] [Accepted: 02/01/2022] [Indexed: 10/27/2022]
Abstract
We propose an emerging conceptualization of "intervention hesitancy" to address a broad spectrum of hesitancy to disease prevention interventions among healthcare personnel (HCP) beyond vaccine hesitancy. To demonstrate this concept and its analytical benefits, we used a qualitative case-study methodology, identifying a "spectrum" of disease prevention interventions based on (1) the intervention's effectiveness, (2) how the intervention is regulated among HCP in the Israeli healthcare system, and (3) uptake among HCP in the Israeli healthcare system. Our cases ultimately contribute to a more nuanced conceptualization of hesitancy that HCP express towards disease prevention interventions. Our case interventions included the seasonal influenza vaccine, the Mantoux test, and the hepatitis B (HBV) vaccine. Influenza and HBV are vaccine-preventable diseases, though their respective vaccines vary significantly in effectiveness and uptake among HCP. The Mantoux test is a tuberculin skin test which provides a prevention benchmark for tuberculosis (TB), a non-vaccine preventable disease. We conducted semi-structured interviews with relevant stakeholders and analyzed them within Israeli and international policy context between 2016 and 2019, a period just prior to the COVID-19 pandemic. We propose the conceptualization of "intervention hesitancy"-beyond "vaccine hesitancy"-as "hesitancy towards a wide range of public health interventions, including but not limited to vaccines". Results suggested that intervention hesitancy among HCP is rooted in weak trust in their employer, poor employment conditions, as well as mixed institutional guidelines and culture. Conceptualizing intervention hesitancy expands the ability of healthcare systems to understand the root of hesitancy and foster a supportive institutional culture and trust, cognizant of diverse disease prevention interventions beyond vaccination.
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Affiliation(s)
- Rachel Gur-Arie
- Berman Institute of Bioethics, Johns Hopkins University, Deering Hall, 1809 Ashland Avenue, 21205, Baltimore, Maryland, USA.
| | - Nadav Davidovitch
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Anat Rosenthal
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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Duodu PA, Darkwah E, Agbadi P, Duah HO, Nutor JJ. Prevalence and geo-clinicodemographic factors associated with hepatitis B vaccination among healthcare workers in five developing countries. BMC Infect Dis 2022; 22:599. [PMID: 35799107 PMCID: PMC9264656 DOI: 10.1186/s12879-022-07556-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background There is a four-fold risk for hepatitis B infection among healthcare workers compared to the general population. Due to limited access to diagnosis and treatment of hepatitis B in many resource-constrained settings, there is a real risk that only few healthcare workers with viral hepatitis may get screened or diagnosed and treated. Studies on hepatitis B vaccination among healthcare workers in developing countries are sparse and this bodes ill for intervention and support. The aim of the study was to estimate the prevalence and explored the associated factors that predicted the uptake of the required, full dosage of hepatitis B vaccination among healthcare workers (HCWs) in five developing countries using nationally representative data. Methods We used recent datasets from the Demographic and Health Surveys Program’s Service Provision Assessment Survey. Descriptive summary statistics and logistic regressions were used to produce the results. Statistical significance was pegged at p < 0.05. Results The proportion of HCWs who received the required doses of hepatitis B vaccine in Afghanistan, Haiti, Malawi, Nepal, and Senegal were 69.1%, 11.3%, 15.4%, 46.5%, and 17.6%, respectively. Gender, occupational qualification, and years of education were significant correlates of receiving the required doses of hepatitis B among HCWs. Conclusions Given the increased risk of hepatitis B infection among healthcare workers, policymakers in developing countries should intensify education campaigns among HCWs and, perhaps, must take it a step further by making hepatitis B vaccination compulsory and a key requirement for employment, especially among those workers who regularly encounter bodily fluids of patients.
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Affiliation(s)
- Precious Adade Duodu
- Department of Nursing and Midwifery, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
| | - Ernest Darkwah
- Department of Psychology, University of Ghana, P.O. Box LG 84, Legon, Ghana
| | - Pascal Agbadi
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, Hong Kong, SAR, China
| | | | - Jerry John Nutor
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, CA, USA.
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Soomar SM, Siddiqui AR, Azam SI, Shah M. Determinants of hepatitis B vaccination status in health care workers of two secondary care hospitals of Sindh, Pakistan: a cross-sectional study. Hum Vaccin Immunother 2021; 17:5579-5584. [PMID: 34757865 DOI: 10.1080/21645515.2021.1986332] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Health care workers (HCWs) are at high risk of Hepatitis B virus (HBV) transmission. Hepatitis B vaccination is effective in protecting against HBV infection. Different factors influence HCW vaccination status such as lack of knowledge & awareness, cost, availability, and hesitancy. This study aimed to determine Hepatitis B vaccination status and factors influencing vaccination status in HCWs of two secondary care hospitals at Sindh, Pakistan. METHODS A cross-sectional study was conducted in two secondary care hospitals of Sindh, Pakistan. A total of 252 doctors, nurses, laboratory, and other HCWs were asked about the HBV vaccination coverage using a structured tool. Multivariable ordinal logistic regression was used to determine the association of participant's characteristics, vaccination knowledge with HBV vaccination coverage considering p-value ≤0.05 significant. Odds ratios with 95% confidence interval (CI) were reported. RESULTS Our study found that 64.9% doctors, 75.18% nurses, 58.3% allied HCWs, 40.0% laboratory staff, and 70.8% housekeeping staff were completely vaccinated. HCWs stated job entry requirement as the primary reason for complete vaccination (AOR 4.6, 95% CI 1.5-5.3) from the disease. HCWs working in Aga Khan hospital Karachi and who have received vaccination before working in that hospital had four-time higher odds for hepatitis B vaccination (AOR 4.3, 95% CI 1.7-4.9). CONCLUSION Two-third of the HCWs were completely vaccinated in secondary care hospitals in Sindh, Pakistan. Hepatitis B vaccination should be made a job entry requirement to achieve more complete vaccination numbers. Vaccination policies require to implement for all part-timers and full-timer health care workers.
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Affiliation(s)
| | | | - Syed Iqbal Azam
- Department of Community Health Sciences Aga, Khan University, Karachi, Pakistan
| | - Mairaj Shah
- Aga Khan University Hospital, Karachi, Pakistan
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Atlaw D, Sahiledengle B, Tariku Z. Hepatitis B and C virus infection among healthcare workers in Africa: a systematic review and meta-analysis. Environ Health Prev Med 2021; 26:61. [PMID: 34078258 PMCID: PMC8173813 DOI: 10.1186/s12199-021-00983-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare workers are at risk of acquiring hepatitis B and C virus infections through patients' blood and bodily fluids exposure. So far, there is no pooled data that shows the prevalence of HBV and HCV among health care workers in Africa. This study aimed to determine the pooled prevalence of hepatitis B and C infections among health care workers in Africa. METHODS Studies reporting the prevalence of HBV and HCV were identified from major databases and gray literature. PubMed, CINAHL, POPLINE, ScienceDirect, African Journals Online (AJOL), and Google Scholar were systematically searched to identify relevant studies. A random-effect model was used to estimate the pooled prevalence of hepatitis B and C among health care workers in Africa. The heterogeneity of studies was assessed using Cochran Q statistics and I2 tests. Publication bias was assessed using Begg's tests. RESULT In total, 1885 articles were retrieved, and 44 studies met the inclusion criteria and included in the final analysis. A total of 17,510 healthcare workers were included. The pooled prevalence of hepatitis B virus infection among health care workers in Africa is estimated to be 6.81% (95% CI 5.67-7.95) with a significant level of heterogeneity (I2 = 91.6%; p < 0.001). While the pooled prevalence of hepatitis C virus infection using the random-effects model was 5.58% (95% CI 3.55-7.61) with a significant level of heterogeneity (I2 = 95.1%; p < 0.001). CONCLUSION Overall, one in fifteen and more than one in twenty healthcare workers were infected by HBV and HCV, respectively. The high burden of HBV and HCV infections remains a significant problem among healthcare workers in Africa.
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Affiliation(s)
- Daniel Atlaw
- Department of Human Anatomy, School of Medicine, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia.
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Science, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Zerihun Tariku
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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Kooffreh-Ada M, Okpokam D, Chukwudike E, Oku A, Ameh S, Effa E. Hepatitis B virus knowledge and vaccination status among health-care workers in Calabar, Nigeria. NIGERIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4103/njm.njm_196_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Getnet MA, Bayu NH, Abtew MD, W/Mariam TG. Hepatitis B Vaccination Uptake Rate and Predictors in Healthcare Professionals of Ethiopia. Risk Manag Healthc Policy 2020; 13:2875-2885. [PMID: 33335433 PMCID: PMC7737625 DOI: 10.2147/rmhp.s286488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 11/17/2020] [Indexed: 12/17/2022] Open
Abstract
Introduction Healthcare professionals continue to be at risk of acquiring occupation-related hepatitis B virus infection because of noncompliance for the 3-dose primary series of hepatitis B vaccine recommended. The objective of the study was to determine the rate of and to identify the predictors of hepatitis B vaccination uptake in healthcare professionals in Ethiopia. Methods A multicenter cross-sectional survey was conducted between May 19 2018 and June 15 2018. A stratified with systematic random sampling technique was used to select 260 healthcare professionals. A structured questionnaire was used to collect all the necessary primary data from samples. This survey analyzed hepatitis B vaccination uptake as the binary outcome variable ("noncomplete" vs "complete") with regard to the 30 potential predictor variables. Both descriptive and inferential statistical analysis techniques have been used to address the study objective. Results The rate of complete vs noncomplete hepatitis B vaccination uptake was 37.7% vs 62.3%. The significantly independent predictors of hepatitis B vaccination uptake were professional qualification (P=0.004), professional experience (P=0.013), household income (P=0.006), workload status (P=0.015), routine infant immunization program existence at the workplace (P=0.014), perceived susceptibility to infection (P=0.005), perceived safety of vaccine (P=0.001), prior occupational exposure to blood (P=0.006), training on universal precautions (P=0.015), and colleagues' suggestion (P=0.002). Conclusion The rate of hepatitis B vaccination uptake found was currently low. The significantly independent predictors of hepatitis B vaccination uptake included perceived safety, colleagues' suggestion, professional qualification, perceived susceptibility, household income, prior occupational exposure to blood, professional experience, existence of routine infant immunization program at the workplace facility, workload status, and universal precautions training.
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Affiliation(s)
- Mehammed Adem Getnet
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Netsanet Habtie Bayu
- Department of Comprehensive Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekdes Dessie Abtew
- Department of Comprehensive Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfamichael G/Mariam W/Mariam
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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A Systematic Review of the Current Hepatitis B Viral Infection and Hepatocellular Carcinoma Situation in Mediterranean Countries. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7027169. [PMID: 32626758 PMCID: PMC7305551 DOI: 10.1155/2020/7027169] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/04/2020] [Accepted: 02/22/2020] [Indexed: 12/13/2022]
Abstract
Viral hepatitis B is a global public health problem affecting nearly two billion subjects; 3.3% of whom are from the WHO (World Health Organization) Eastern Mediterranean Region (EMRO). It induces both acute and chronic hepatic disorders with subsequent liver cirrhosis and hepatocellular carcinoma (HCC) in a considerable percentage of patients based on the age of exposure. In this review, hepatitis B virus (HBV) and HCC prevalence, distribution and prevalence of different genotypes, and male/female infection frequencies in relation to the vaccination status in the Mediterranean countries were reported. Study Design. This systematic review describes the prevalence of hepatitis B infection, genotype distribution of hepatitis B virus, and prevalence and incidence of hepatocellular carcinoma in Mediterranean countries belonging to three different continents: Southern Europe (Spain, France, Italy, Croatia, and Greece), North Africa (Morocco, Algeria, Tunisia, Libya, and Egypt), and the Near East region (Syria, Lebanon, Turkey, Israel, and Palestine). We tried to collect new data from electronic databases: PubMed, ScienceDirect, ResearchGate, Google Scholar, and public health reports between 1980 and 2019. For each publication, we recorded reference, publication year, study characteristics (date, locations, sample size, and study population), and participant characteristics (population group, year, age, and sex). No language limitation was imposed, and articles or reports from non-peer-reviewed sources were not considered for this analysis. The main keywords were HBV prevalence, hepatitis B infection, HBV genotype, and HCC. Inclusion and Exclusion Criteria. Healthy population-based studies included the following sample populations: (i) voluntary blood donors, (ii) pregnant women, (iii) community studies, (iv) hemodialysis patients, (v) hospitalized patients, (vi) healthcare workers, (vii) sex workers, (viii) drug abusers, and (ix) prisoners. We excluded studies from the following special groups who were assumed to be at a special high risk: patients from sexually transmitted disease clinics and thalassemia clinics and professional or paid blood donors.
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Al-Abhar N, Moghram GS, Al-Gunaid EA, Al Serouri A, Khader Y. Occupational Exposure to Needle Stick Injuries and Hepatitis B Vaccination Coverage Among Clinical Laboratory Staff in Sana'a, Yemen: Cross-Sectional Study. JMIR Public Health Surveill 2020; 6:e15812. [PMID: 32229462 PMCID: PMC7157492 DOI: 10.2196/15812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 01/26/2020] [Accepted: 02/12/2020] [Indexed: 11/24/2022] Open
Abstract
Background Laboratory staff handling blood or biological samples are at risk for accidental injury or exposure to blood-borne pathogens. Hepatitis B virus (HBV) vaccinations for laboratory staff can minimize these risks. Objective The aims of this study were to determine the prevalence of occupational exposure to needle stick injuries (NSIs) and assess HBV vaccination coverage among clinical laboratory staff in Sana’a, Yemen. Methods A cross-sectional survey was conducted among clinical laboratory staff who were involved in handling and processing laboratory samples at the main public and private clinical laboratories in Sana’a. Data collection was done using a semistructured questionnaire. The questionnaire was divided into 3 parts. Part 1 included information on sociodemographic characteristics of participants. Part 2 included information on the availability of the personal protective equipment in the laboratories, such as lab coats and gloves. Part 3 included questions about the history of injury during work in the laboratory and the vaccination status for HBV. Results A total of 219/362 (60%) participants had been accidentally injured while working in the laboratory. Of those, 14.6% (32/219) had been injured during the last 3 months preceding the data collection. Receiving the biosafety manual was significantly associated with lower risk of injury. Out of those who were injured, 54.8% (120/219) had received first aid. About three-quarters of respondents reported that they had been vaccinated against HBV. The vaccination against HBV was significantly higher among laboratory staff who were working at private laboratories (P=.01), who had postgraduate degrees (P=.005), and who received the biosafety manual (P=.03). Conclusions Occupational exposure to NSI is still a major problem among laboratory staff in public and private laboratories in Sana’a, Yemen. The high incidence of injuries among laboratory staff and the low rate of receiving first aid in laboratories combined with low vaccination coverage indicates that all laboratory staff are at risk of exposure to HBV. Therefore, strengthening supervision, legalizing HBV vaccinations for all laboratory staff, and optimizing laboratory practices regarding the management of sharps can minimize risks and prerequisites in Yemen.
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Affiliation(s)
- Nabil Al-Abhar
- Field Epidemiology Training Program, Sana'a, Yemen.,National Center of Public Health Laboratories, Sana'a, Yemen
| | | | | | | | - Yousef Khader
- Jordan Field Epidemiology Training Program, Jordan Ministry of Health, Amman, Jordan
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Garbin CAS, Wakayama B, Saliba TA, Saliba OA, Garbin AJÍ. A cross-sectional study on dental surgeons' immune status against hepatitis B virus in the Public Health System. Rev Inst Med Trop Sao Paulo 2020; 62:e18. [PMID: 32130358 PMCID: PMC7051181 DOI: 10.1590/s1678-9946202062018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 02/03/2020] [Indexed: 12/15/2022] Open
Abstract
Hepatitis B is a severe public health problem. The main world health centers have discussed it due to its pandemic proportion, high pathogenicity and infectivity. This study aimed to determine the immunization profile of dental surgeons - against hepatitis B virus (HBV) in the Public Health System (PHS) through the detection of anti-HBsAg antibodies by immunochromatography and associations with dental surgeons' social and educational profile, factors related to professional knowledge and practices. This is a cross-sectional study on the prevalence of vaccination and immune status to HBV in dentists of Sao Paulo State PHS. Data collection occurred in three stages: questionnaire application, analysis of adhesion to the vaccination protocol and anti-HBsAg tests. Statistical analysis used the Bivariate Analysis and the Binary Logistic Regression. From the total of 219 interviewees, 74.9% reported having received three doses of the vaccine, but 35.6% were not immune to HBV. The dependent variable was associated with years in the public service (years) (OR [Odds Ratio]=1.04; 95% CI 1.00-1.08); knowledge on the subject (OR=6.93; 95% CI 1.39-34.40); incorrect answer concerning the etiological agent of the disease (OR=2.60; 95% CI 1.30-5.22); ignorance on the number of vaccine doses that have been administered (OR=3.43; 95% CI 1.14-10.30); and less than three doses of the vaccine in the immunization schedule (OR=8.76; 95% CI 3.50-21.91). A considerable portion of professionals non-immune to the HBV were found. We concluded that knowledge, years of practice and completion of the vaccination schedule (three doses) affected dental surgeons' immune status to HBV.
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Affiliation(s)
- Clea Adas Saliba Garbin
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Programa de Pós-Graduação em Odontologia Preventiva e Social, Araçatuba, São Paulo, Brazil
| | - Bruno Wakayama
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Programa de Pós-Graduação em Odontologia Preventiva e Social, Araçatuba, São Paulo, Brazil
| | - Tânia Adas Saliba
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Programa de Pós-Graduação em Odontologia Preventiva e Social, Araçatuba, São Paulo, Brazil
| | - Orlando Adas Saliba
- Centro Universitário Católico Salesiano Auxilium, Curso de Medicina, Araçatuba, São Paulo, Brazil
| | - Artênio José Ísper Garbin
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Programa de Pós-Graduação em Odontologia Preventiva e Social, Araçatuba, São Paulo, Brazil
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Babanejad M, Izadi N, Alavian SM. A Systematic Review and Meta-analysis on the Prevalence of HBsAg in Health Care Workers from Eastern Mediterranean and Middle Eastern Countries. Int J Prev Med 2019; 10:144. [PMID: 31516685 PMCID: PMC6716224 DOI: 10.4103/ijpvm.ijpvm_111_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/29/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The present study aimed to determine the prevalence of HBsAg in Health Care Workers (HCWs) in Eastern Mediterranean Region Office (EMRO) and Middle Eastern countries from 2000 to 2016. METHODS In a meta-analysis study, the databases of PubMed, ISI, Ovid, Scopus, Google Scholar, and Persian databases were searched for relevant articles on the prevalence of HBsAg in HCWs in EMRO and Middle Eastern countries. Homogeneity was assessed based on Cochran's Q-test results. RESULTS A total of 43 articles (110,179 people) were included. The pooled prevalence of HBsAg in HCWs of EMRO and Middle East countries was found 2.77% (95%CI: 2.64-2.83). The specific prevalence of HBsAg was 2.84% (95% CI: 2.6-3.11) in EMRO and 2.22% (95%CI: 2.13-2.31) in Middle Eastern countries. The highest and lowest prevalence rates of HBsAg among HCWs for countries with more than one study were 6.85% (95% CI: 5.74%-8.16%) in Sudan and 1.00% (95% CI: 0.94%-1.07%) in Turkey, respectively. The trends of HBsAg prevalence among HCWs decreased from 2000 to 2016. CONCLUSIONS Based on the World Health Organization classification of HBV prevalence, intermediate HBsAg prevalence rates were detected in HCWs of EMRO and Middle East countries during 2000-2016.
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Affiliation(s)
- Mehran Babanejad
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Neda Izadi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed M. Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Auta A, Adewuyi EO, Kureh GT, Onoviran N, Adeloye D. Hepatitis B vaccination coverage among health-care workers in Africa: A systematic review and meta-analysis. Vaccine 2018; 36:4851-4860. [PMID: 29970299 DOI: 10.1016/j.vaccine.2018.06.043] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 06/05/2018] [Accepted: 06/18/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To estimate full hepatitis B vaccination coverage (uptake of ≥3 doses of vaccine) among health-care workers (HCWs) in Africa. METHODS We systematically searched the PubMed®, Embase®, CINAHL and Psych-Info databases for studies published from January 2010 to October 2017 that reported full hepatitis B vaccination coverage among HCWs in Africa. A random effects meta-analysis was conducted to determine pooled estimates of full vaccination coverage. RESULTS Of the 331 articles identified, 35 studies from 15 African countries met the inclusion criteria and were included in the review. The estimated full hepatitis B vaccination coverage was 24.7% (95% CI: 17.3-32.0). Regional coverage was highest in northern Africa (62.1%, 95% CI: 42.5-81.7) and lowest in central Africa (13.4%, 95% CI: 4.5-22.3). Doctors were more likely (OR: 2.6, 95% CI: 1.8-3.7) to be fully vaccinated than Nurses with estimated pooled estimates of 52.4% (95% CI: 31.1-73.8) and 26.3% (95% CI: 9.7-42.9), respectively. Also, HCWs with 10 or more years of experience were more likely to be vaccinated than those with less than 10 years of experience (OR: 2.2, 95% CI: 1.5-3.3). The common reasons identified for non-vaccination of HCWs were unavailability of vaccine 50.5% (95% CI: 26.5-74.4), busy work schedule 37.5% (95% CI: 12.6-62.4) and cost of vaccination 18.4% (95% CI: 7.1-29.7). CONCLUSION The evidence available suggests that many HCWs in Africa are at risk of Hepatitis B infection as only a quarter of them were fully vaccinated against Hepatitis B virus. This study highlights the need for all African governments to establish and implement hepatitis B vaccination policies for HCWs.
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Affiliation(s)
- Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, United Kingdom.
| | - Emmanuel O Adewuyi
- Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Gbednet T Kureh
- Department of Pharmacology, Faculty of Medicine, St Francis University College of Health and Allied Sciences, Ifakara, Tanzania
| | | | - Davies Adeloye
- Centre for Global Health Research and the World Health Organization Collaborating Centre for Population Health Research and Training, Usher Institute, University of Edinburgh, United Kingdom
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Akibu M, Nurgi S, Tadese M, Tsega WD. Attitude and Vaccination Status of Healthcare Workers against Hepatitis B Infection in a Teaching Hospital, Ethiopia. SCIENTIFICA 2018; 2018:6705305. [PMID: 29808158 PMCID: PMC5901831 DOI: 10.1155/2018/6705305] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 02/05/2018] [Accepted: 03/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND World Health Organization and Centers for Disease Control and Prevention recommend all health professionals to get vaccinated against hepatitis B virus before they start the clinical attachments during their stay in the medical school. However, only 18-39% of healthcare workers in low- and middle-income countries received the vaccine. Therefore, this study aims to determine the attitude and vaccination status of health professionals working at Adama General Hospital and Medical College. METHODS An institution-based cross-sectional study was conducted from December 2016 to February 2017 with 403 health professionals working at Adama General Hospital and Medical College. Data were collected using self-administered questionnaire distributed at the participant's work unit and analyzed using SPSS version 20. Multiple logistic regression analysis was conducted to identify factors that affect the complete vaccination status and p value < 0.05 was considered statistically significant. RESULT The prevalence of complete vaccination against hepatitis B virus was 25.6%. The most frequently mentioned reasons for not being vaccinated were high cost of the vaccine (41%) and unavailability of the vaccine (36%). More than three-fourths (77.8%) of study participants strongly agreed that hepatitis B is a major public health threat and there was tendency among participants to believe that their profession will put them at increased risk of acquiring the disease (strongly agreed: 75.9%). Attending infection-prevention training [AOR = 2.3; 95% CI, 1.24-6.31], history of exposure to risky behavior [AOR = 5.5; 95% CI, 2.86-9.29], and long years of work experience [AOR = 3.1; 95% CI, 1.98-5.24] were statistically significant with complete vaccination status. CONCLUSION Only one-quarter of health professionals received the recommended full dose of the vaccine. Sustained hepatitis B vaccination programs for healthcare workers need to be established by collaboration of different stakeholders to optimize health professionals' safety against this contagious infection.
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Affiliation(s)
- Mohammed Akibu
- Department of Midwifery, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Sodere Nurgi
- Department of Midwifery, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Mesfin Tadese
- Department of Midwifery, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Wendwesen Dibekulu Tsega
- Department of Public Health, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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Elzouki AN, Elgamay SM, Zorgani A, Elahmer O. Hepatitis B and C status among health care workers in the five main hospitals in eastern Libya. J Infect Public Health 2014; 7:534-41. [PMID: 25151657 DOI: 10.1016/j.jiph.2014.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/19/2014] [Accepted: 07/11/2014] [Indexed: 12/17/2022] Open
Abstract
The aim of the present study was to determine the frequency of hepatitis B and C transmission to health care workers (HCWs) in five major hospitals in eastern Libya and to analyze how the risk of these infections are affected by the type of occupation, hospital work place and working period. From July 2008 to June 2009, 601 HCWs (mean age: 32.90 ± 8.85 years) were tested for HBV and HCV markers using ELISA techniques. Polymerase chain reaction (PCR) was performed on all positive samples of HBsAg and Anti-HCV antibody to determine the level of HBV-DNA and HCV-RNA viremia, respectively. The overall frequency of HBsAg positivity was 1.8%. Anti-HBc, HBeAg and Anti-HBe antibodies were found in 8.5%, 0.7% and 8.0% of samples, respectively. The HBV-DNA level was positive in 55% of all HBsAg-positive samples. Approximately half of the HCWs (51.4%) were Anti-HBs antibody positive. The overall positivity rate of Anti-HCV antibodies was 2.0%, and HCV-RNA was positive in 33.3% of these samples. Overall, 52% of HCWs reported receiving full vaccination doses (three doses) against HBV infection. Among them, anti-HBs positivity was approximately 98.0%. 3.9% of those who never received any HBV vaccination dose were HBsAg positive, compared to 1.3% HBsAg positive in those HCWs who had received one or two doses of hepatitis B vaccine (p=0.01 for all comparisons). Nurses and nurse-aides had the highest rates of both HBsAg and Anti-HCV among the studied HCWs (HBsAg: 2.1% and 3.2%; Anti-HCV: 3.2% and 4.9%, respectively). It is noteworthy that doctors also had a relatively high prevalence rate of Anti-HCV (2.2%). Obstetric wards, isolation room, dialysis units and dentist work places had higher frequencies of HBV. HCV was found to be higher in the medical and surgical wards (the prevalence varied between 3% and 5.6%). There was no significant difference between HBsAg status and the work period of HCWs. In conclusion, universal precautions should be applied for the care of all patients by all HCWs. Further, HBV vaccines should be more readily available for Libyan HCWs by reinforcing current vaccination programs.
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Affiliation(s)
- Abdel-Nasser Elzouki
- Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Weill Cornell Medical College, Qatar.
| | | | - Abdeulaziz Zorgani
- Department of Microbiology and Immunology, Faculty of Medicine, Tripoli University, Tripoli, Libya
| | - Omer Elahmer
- National Center for Diseases Control, Tripoli, Libya
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Wang B, Zhu Z, Zhu B, Wang J, Song Z, Huang S, Fan W, Tao Y, Wang Z, Wang H, Lu M, Yang D. Nucleoside analogues alone or combined with vaccination prevent hepadnavirus viremia and induce protective immunity: alternative strategy for hepatitis B virus post-exposure prophylaxis. Antiviral Res 2014; 105:118-25. [PMID: 24583157 DOI: 10.1016/j.antiviral.2014.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/18/2014] [Accepted: 02/19/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The current strategies for hepatitis B virus (HBV) post-exposure prophylaxis (PEP) are not generally available in remote and rural areas of developing countries and/or carry potential risks for infection with blood-borne transmitted pathogens. Nucleotide analogues (NAs) are successfully used for human immunodeficiency virus PEP, and maybe effective for HBV PEP. In this study, we tested the NA-based strategies for HBV PEP using the Chinese woodchuck model. METHODS Chinese woodchucks were inoculated intravenously with different doses of woodchuck hepatitis virus (WHV). A deoxyguanosine analogue entacavir (ETV), a DNA vaccine pWHcIm, or ETV plus pWHcIm were applied to the infected animals 24h later. Twenty weeks later, the animals were re-challenged with WHV to test for the presence of immunity against WHV. RESULTS Inoculation with different WHV doses had a strong influence on the course of WHV infection; NA alone or in combination with a DNA vaccine completely prevented viremia after a high dose of WHV inoculation in Chinese woodchucks and induced partial or complete protective immunity, respectively. CONCLUSIONS NA-based PEP strategies (NA alone or in combination with vaccine) may be an alternative of HBV PEP, especially in those living in the remote and rural areas of the developing countries and the non-responders to the current vaccine, and may be valuable in the PEP of HBV and HIV co-infection after occupational and non-occupational exposure. Further clinical studies are warranted to confirm the valuable of NA-based strategies in HBV PEP.
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Affiliation(s)
- Baoju Wang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zhenni Zhu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Bin Zhu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Junzhong Wang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zhitao Song
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Shunmei Huang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Wei Fan
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, China
| | - Yuanqing Tao
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, China
| | - Zhongdong Wang
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, China
| | - Hu Wang
- Qinghai Institute for Endemic Disease Prevention and Control, Xining 811602, China
| | - Mengji Lu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Institut für Virologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen 45122, Germany.
| | - Dongliang Yang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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